IDIOPATHIC SLOW-TRANSIT CONSTIPATION: MECHANISMS OF DEVELOPMENT AND TREATMENT POTENTIALS


Cite item

Full Text

Abstract

The article is dedicated to the features of idiopathic slow-transit constipation (ISTC) of unknown etiology (Russian equivalent - chronic colonic stasis), sporadic disease, which differs from irritable bowel syndrome, symptomatic, proctogenic and other forms of constipation. ISTC occurs mainly in women (70-80%), this pathology develops in early childhood or adolescence, long life persist, and is very refractory to medical treatment. The article discusses the pathophysiology of ISTC, in which the imbalance of intestinal regulatory peptides and neurotransmitters, including opioids (enkephalines and endorphins) plays important role. It is emphasized that trimebutin (Trimedat) is the only really available drug that stimulates the motor activity of the colon, and this drug is full agonist for all three types of opioid receptors. Available clinical data show positive therapeutic effects of trimebutine on the various functions of the gastrointestinal tract, including stimulation of activity of colon smooth muscles in patients with ISTC .

References

  1. Murray C, Emmanuel A. Colonic Disorders. p. 148-160. In:Pathophysiology of the Enteric Nervous System. Ed. Spiller R, Grundy D. Blackwell, 2004.
  2. Kamm MA, Lennard-Jones JE. Colonic motor activity in constipation. Constipation 1994:65-72.
  3. Peracchi M, Basilisco G, Tagliabue R, et al. Postprandial Gut Peptide Plasma Levels in Women with Idiopathic Slow-Transit Constipation. Scand J Gastroenterol 1999;34(1):25-28.
  4. Белоусова Е.А. Возможности лечения запора у пожилых пациентов // Врач 2002. № 5. С. 47-49.
  5. Кукес В.Г. Клиническая фармакология. М., 2006.
  6. Белоусова Е.А., Румянцев В.Г., Мишуровская Т.С. Новые возможности сандостатина (октреотида) в гастроэнтерологии // Клиническая фармакология и терапия 2000. № 1. С. 16-19.
  7. Lluis F, Thompson JC. Neiroendocrine Potential of the Colon and Rectum. Gastroenterology 1988;94:832-44.
  8. Milner P, Burnstock G, Kamm MA, et al. Neurotransmitters in the gut Constipation 1994:41-49.
  9. Maselli MA, Riezzo G, Pezzolla F. Motor responsiveness of proximal and distal human colonic muscle layers to carbachol and neurotensin. Dig Dis Sci 1998;43(8):1685-89.
  10. Akkermans LMA, van der Heide D, Kamm MA et al. Metabolic and endocrine factors in constipation. Constipation 1994:59-64.
  11. Bueno L, Fioramonti J, Kamm MA, et al. Central control of colonic motility: possible involvement in constipation. Constipation 1994:51-58.
  12. Gyr R, Meier R. Pharmacodynamic effects of Sandostatin in the gastrointestinal tract. Digestion 1993;54(1):14-19.
  13. Овсянников В.И. Нейромедиаторы и гормоны в желудочно-кишечном тракте. СПБ. 2003. С. 136.
  14. Peracchi M, Basilisco G, Tagliabue R, et al. Postprandial Gut Peptide Plasma Levels in Women with Idiopathic Slow-Transit Constipation. Scand J Gastroenterol 1999;34(1):25-28.
  15. Sijp van der JRM, Kamm MA,Nightigale JMD, et al. Circulating gastrointestinal hormone abnormalities in patients with severe idiopathic constipation. Amer J Gastroenterol 1998;93(8):1351-56.
  16. Christensen J, Kamm MA, Lennard-Jones JE. Morphology of the innervation of large intestine and the neuropathology of constipation. Constipation 1994:33-40.
  17. Cortesini C, Cianchi F, Infantino A, et al. Nitric oxide syntheses and VIP distribution in enteric nervous system in idiopathic constipation. Dig Dis Sci 1995;40(11):2450-55.
  18. Corbett A, McKnight S, Henderson G. Opioid Receptors. Pub. 1999. Scientific Reviews. Torcis bioscience. www.torcis.com Delvaux M, Wingate D. Trimebutine: mechanism of action, effects on gastrointestinal function and clinical results. J Int Med Res 1997;25(5):225-46.
  19. Holzer Р. Opioid receptors in the gastrointestinal tract. Regulatory Peptides 2009;155(1-3):11-13.Taguchi АК, Sharma N, Saleem RM, et al. Selective postoperative inhibition of gastrointestinal opioid receptors. N Engl J Med 2001;345:13.
  20. Holzer Р. Opioids and opioid receptors in the enteric nervous system: from a problem in opioid analgeto a possible new prokinetic therapy in humans. Neuroscience Lettersю 2004, v.361 (1-3). р. 192-195
  21. DeHaven-Hudkins DL, DeHaven RN, Little PJ, et al. The involvement of the mu-opioid receptor in gastrointestinal pathophysiology: therapeutic opportunities for antagonism at this receptor. Pharmacol Ther. 2008;117(1):162-87.
  22. Kraft MD. Methylnaltrexone, a new peripherally acting mu-opioid receptor antagonist being evaluated for the treatment of postoperative ileus. Expert Opin Investig Drugs 2008;17(9):1365-77.
  23. Neyens R, Jackson KC. Novel opioid antagonists for opioid-induced bowel dysfunction and postoperative ileus. J Pain Palliat Care Pharmacother 2007;21(2):27-33.
  24. Liu BH, Mo P, Zhang SB. Effects of mu and kappa opioid receptor agonists and antagonists on contraction of isolated colon strips of rats with cathartic colon. World J Gastroenterol 2004;10(11):1672-74.
  25. Ивашкин В.Т., Драпкина О.М. Современные возможности применения тримебутина в лечении хронической абдоминальной боли // РЖГГК 2008. № 5. С. 12-16.
  26. Kountouras J. Efficacy of trimebutine therapy in patients with gastroesophageal reflux disease and irritable bowel syndrome. Hepatogastroenterology 2002;49(43):193-97.
  27. Тропская Н.С., Попова Т.С. Механизм действия тримебутина в коррекции функциональных расстройств желудочно-кишечного тракта. Клиническая гастроэнтерология и гепатология // Русское издание. 2008. Т. 1. № 4. С. 1-4.
  28. Aktas А, Caner В, et al. The effect of trimebutine maleate on gastric emplying in patients with non- ulcer dyspepsia. Аnnals of nuclear Medicine 1999;13(4):231-34.
  29. Zhong YO, Zhu J, Guo JN, et al. Рандомизированное клиническое исследование методом случай-контроль при лечении тримебутина малевтом функциональной диспепсии, сопровождающейся синдромом раздраженного кишечника с диареей // Клиническая гастроэнтерология и гепатология. Русское издание. 2008. Т. 1. № 4. С. 5-8.
  30. Barthet M. Effect of trimebutine on of Oddi motility in patients with post-cholecystectomy pain. Aliment Pharmacol Ther 1998l;12(7):647-52.
  31. Schang JC, Devroede G, Pilote M. Effects of trimebutine on colonic function in patients with chronic idiopathic constipation: evidence for the need of a physiologic rather than clinical selection. Dis Colon Rectum 1993;36(4):330-36.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies